Sunday March 17, 2013

Associated Press

CONCORD, N.H. -- As New Hampshire prepares for the new insurance markets required under the federal health care overhaul, a recent survey highlights how little residents agree on or even know about the looming changes.

New Hampshire Voices for Health -- a network of more than 40 organizations that advocates for affordable, quality health care -- hired an independent consultant to design and administer an online survey seeking input on how the marketplace should operate in New Hampshire.

State insurance and health and human service officials helped develop the questions. The survey was distributed in late January to industry associations and advocacy groups representing health care providers, insurers, consumers and businesses, with requests that it be shared widely both within and outside each organization.

By the time the survey ended early this week, 648 people had responded, according to results provided to The Associated Press. And while the survey was unscientific, its findings suggest that much work remains to be done to inform and educate businesses about the health insurance marketplaces.

Under the new health care law, middle class people will be eligible for tax credits to help pay for private insurance plans, while low-income people will be steered to safety-net programs such as Medicaid. Enrollment begins Oct. 1 for coverage that takes effect Jan. 1.

Because a state law prohibits New Hampshire from building its own market, the state will have a federally run system, though the state will partner with the federal government to regulate insurers and provide consumer assistance. But many details have yet to be worked out, leaving some survey participants frustrated.

"It is currently a mystery to me how this will work out," wrote one small business owner.

Another participant, who plans to retire in July and then seek coverage through the market, described a fruitless search for information.

"I have tried to do my homework but everyone (insurance companies, state insurance reps, my human resources department) tells me that they have no information and will not have any until at least October. This leaves me unable to plan," the survey participant wrote.

Those kinds of comments, and similar testimony given at a public hearing earlier this month, highlight the urgent need for consumer assistance efforts that will "reach people where they’re at," said Lisa Kaplan Howe, policy director at Voices for Health.

Confusion aside, there was some consensus among survey participants in some areas. Asked how much the marketplace should prioritize a series of characteristics, more than 90 percent said providing people with accurate, easily comparable information about health plans should be a high priority.

Most participants said they don’t trust the government to provide them with information about the marketplace and their health plan options. About 40 percent said they would trust a local nonprofit group, compared with 14 percent who said state officials and 9 percent who said federal officials. Other groups, including the media, health care providers and insurance brokers, were viewed as even less trustworthy.

More than half the participants said there should be a balance between making a lot of insurance plans available so people have as many choices as possible and making sure the plans are standardized and limited so people can easily compare their options.